1. family and parenting
2. motherhood
3. pregnancy

BRIEF COMMUNICATION
Iran J Allergy Asthma Immunol
April 2015; 14(2):217-221.
HLA-G5 and G7 Isoforms in Pregnant Women
Saeid Abediankenari1, Faramars Farzad2, Zahra Rahmani3, and Mohammad Bagher Hashemi-soteh1
1
Immunogenetic Research Center, Faculty of Medicine, Mazandaran University
of Medical Sciences, Sari, Iran
2
Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
3
Department of Obstetrics, Faculty of Medicine, Mazandaran University
of Medical Sciences, Sari, Iran
Received: 27 October 2013; Received in revised form: 12 January 2014; Accepted: 25 May 2014
ABSTRACT
Human leukocyte antigen-G which is an immune tolerance effecter molecule has an
important role in the maintenance of fetus during pregnancy. Abortion is one of the
complications of pregnancy period. In this research, we have studied levels of HLA-G 5,
HLA-G7 isoforms in the abortion-threatened pregnant women in comparison with controls.
In a case-control study, 101 abortion-threatened women and 101 healthy pregnant
women (healthy controls) with age range 21-32 years were studied. Gene expression of
HLA-5 and HLA-7 isoforms was analyzed by real-time polymerase chain reaction after
mRNA extraction and cDNA synthesis.
The results indicated that HLA-G5 was significantly lower in abortion-threatened women
in comparison with the control group whereas HLA-G7 was not significantly
differentbetween the 2 groups.
HLA-G is a vital molecule during pregnancy that can be a key factor in prevention of
abortion. It is concluded that determination of HLA-G5 can be of value in pregnancy.
Keywords: Abortion; HLA-G; Pregnancy
INTRODUCTION
Abortion is an important complication during
pregnancy. Annually, 20% of pregnancies fail because
of unknown factors.1,2
During pregnancy, immune system plays a key role
in maintenance of fetus. Human leukocyte antigen-G
(HLA-G) has 7 isoforms including: HLA-G1, G2, G3,
G4, G5, G6, and G7.3 HLA-G1, G2, G3 and G4 are
Corresponding Author: Saeid Abediankenari, PhD;
Faculty of Medicine, Mazandaran University of Medical Sciences,
Sari, Iran. Tel: (+98 912) 1985 667, E-mail: abedianlab@yahoo.co.uk
surface molecules and HLA-G5, G6, G7 are soluble
molecules.4 It has been demonstrated that HLA-G
increases in cancer, transplantation, and infectious
diseases.5 This molecule has an interesting role in
pregnancy.6 HLA-G is expressed on the trophoblastic
cells in placenta and reacts with inhibitory receptors on
natural killer cells (NK) and T cells.7 Therefore, it
prevents maternal uterine natural killer cell attack against
fetus. Up to now, many studies reported the role of
HLA-G molecules in some diseases.4,8,9 It has been
previously reported that HLA-G was up-regulated after
Interferon Beta(IFN- β) therapy and prevented unwanted
Copyright© Spring 2015, Iran J Allergy Asthma Immunol. All rights reserved.
Published by Tehran University of Medical Sciences (http://ijaai.tums.ac.ir)
217
S. Abediankenari, et al.
reaction in diabetes type 1.10 In addition, HLA-G is an
important molecule in immune tolerance between
mother and fetus which has a basic role to preventfetal
loss. Furthermore, it has a key role in the blastocysts
development and induction of ovum replacement.11 The
role of HLA-G different isoforms is less known in
pregnancy.
Thus, we evaluated HLA-G5 and G7 isoforms in
abortion-threatened women in comparison with healthy
pregnant women.
MATERIALS AND METHODS
In a case-control study, 101 abortion-threaened
women and 101 healthy pregnant women (control) with
age range of 21-32 years were included. Informed
consent was obtained and the study was approved by
Mazandaran University Ethical Committee. The
participants referred to obstetrics clinic in Mazandaran
province of Iran before twenty weeks of pregnancy
(Table1).
Isolation of Human Peripheral Blood Mononuclear
Cells (PBMCs)
5 ml peripheral blood after dilution was added gently
to 2.5 ml Ficoll histopaque 1.077 (Lymphoprep,
Norway) solution in a falcon tube and centrifuged at
3000 rpm for 20 minutes. A ring including mononuclear
cells collected and was washed by RPMI-1640 medium
(Sigma, USA) and centrifuged at 3000 rpm for 5
minutes. Then, cell counting was done with a
hemocytometer and trypan blue exclusion test was
determined for cell viability.
Total RNA Isolation, mRNA Extraction and cDNA
Synthesis
Gene expression of HLA-G5 and -G7 isoforms was
analyzed by Real time polymerase chain reaction (RTPCR) after mRNA extraction and cDNA production
from PBMCs.
Total RNA extraction was performed using standard
kit in accordance to manufacturer’s protocol (Bioneer,
South Korea). A DNase treatment was included in the
procedure for elimination of any genomic DNA (Qiagen,
Hilden, Germany).The cDNA production kit (Fermentas
Germany) was used for cDNA synthesis.
RT-PCR
Quantitative RT-PCR was performed using specific
primers for HLA-G5 and -G7 and hypoxanthineguanine phosphoribosyl transferase (was chosen as a
reference gene) genes (Table 2) with the QuantiFast
SYBR Green PCR Master Mix.
Quantitative RT-PCR reactions were performed in a
20 μL volume containing 1× QuantiTect SYBR Green
PCR master mix (Qiagen, Hilden, Germany), 1 μM of
forward and reverse primers and 1 μL of first strand
cDNA according to manufacturer's procedure. After an
Table 1. Demographic characteristics and some clinical parameters of case and control groups
Age (y) (mean±SD)
Recurrent abortion (mean±SD)
Weight (mean±SD)
Blood sugar (mean±SD)
Hemoglobin (mean±SD)
Hematocrit (mean±SD)
Blood urea nitrogen (mean±SD)
Creatinin (mean±SD)
T4
TSH (mean±SD)
VDRL
Hepatitie B surface antigen
Immunosuppressive Drug Consumption
Familial disorders
Vol. 14, No. 2, April 2015
Abortion-threatened women
(No=101)
Healthy pregnant
women (No=101)
P value
25.43±3.23
1.4±0.57
66.80±6.50
87.73±8.3
11.87±0.6
36.33±1.97
25.43±3.23
0.75±0.23
7.32±2.52
2.04±1.47
Negative
Negative
Negative
Negative
24.01±2.43
66.02±7.66
88.5±9.04
12.07±0.6
35.7 ± 1.810
24.01±2.43
0.68±0.14
8.09±2.43
2.66±1.29
Negative
Negative
Negative
Negative
0.373
0.799
0.124
0.667
0.412
0.373
0.657
0.257
0.077
-
Iran J Allergy Asthma Immunol, Spring 2015 /218
Published by Tehran University of Medical Sciences (http://ijaai.tums.ac.ir)
HLA-G5 and Threatened- Abortion Women
Table 2. Primer sequences used in this research
HLA
HLA-G5
HLA-G7
HGPRT
Sequence
5-CGGAGTATTGGGAAGAGGAGA-3
5-TGGTACCCGCGCGCTGCAG-3
5-GGGCTACGGAATGAAGTTCTC-3
5-GCACTCACCCGCCCAGGTC-3
5-CTAATTATGGACAGGACTGAACG-3
5-TTGACTGGTCATTACAATAGCTC-3
Exon
bp
Exon3
Exon4-Intron4
Exon1-2
Exon2-Intron2
Exon12-3
Exon4-3
388
169
211
Table 3. HLA-G expression in the PBMCs of abortion-threatened women (cases) in comparison with healthy pregnant
women (controls) by RT-PCR. The results are mean ± SD. Statistically significant differences between groups were tested using
students T test.
HLA
Fold change
Control Group
1.12±0.41
1.64±0.55
HLA-G7 (Mean±SD)
HLA-G5 (Mean±SD)
initial 5-min at 95°C as activation step, 40 cycles
consisting of denaturation at 95°C, 10 s; annealing
and extension at 60°C, 30 s were performed. In each
PCR run, preparation of standard curve was carried
out by serial dilution of cDNA from samples.
Expression was assayed by comparison with the
standard curve of the specific target and reference gene
in each PCR run.
Statistical Analysis
For statistical analysis, we used paired t-tests. The
p values were determined in all cases and were
considered to be significant at p<0.05). Data are
presented as mean ± SD.
RESULTS
General Characteristics
In this case–control study, a total of 202 individuals
were included.
HLA-G Isoforms Expression on PBMC
There was a significant decrease in HLA-G5 level
in abortion-threatened pregnant women in comparison
with healthy pregnant women (Table 3; p=0.0001).
HLA-G7 expression in patients (threatened-abortion)
was less than control group. In control group, HLA-G5
and G7 showed an increase in comparison with
threatened-abortion women.
P value
Case Group
1.03±0.47
0.4±0.16
0.241
0.0001
DISCUSSION
In the present study, we evaluated two immunetolerance molecules (HLA-G5 and G7) in PBMC of
healthy pregnant women as control in comparison with
abortion-threatened women before twenty weeks of
pregnancy. The studies have demonstrated that
mononuclear cell-bearing HLA-G acquires tolerogenic
potential to down regulate various immune
activities.6,10,12,13 Our results showed that HLA-G5 and
G7 isoforms were down regulated in the abortionthreatened women (Figure1). It means that these
molecules are transiently up-regulated after pregnancy.
Many studies demonstrated that women's age is one of
the important factors in abortion.14,15 Sipak et al (2007)
showed that the level of soluble HLA-G in some
isoforms is different from the others.16 In this research,
HLA-G5 expression level was higher than HLA-G7 in
healthy pregnant women and HLA-G5 level was lower
than HLA-G7 in abortion-threatened women.
Thus, it is recommended that determination of
HLA-G5 as a soluble isoform may be a marker in
pregnancy. Probably, expression of HLA-G5 isoform is
controlled by genetic factors. Furthermore, HLA-G5
may be a major isoform in tolerance between mother
and fetus that its determination may be a key factor in
prevention of fetal loss.
HLA-G5 in comparison with the other isoforms was
up regulated in the healthy pregnant women. HLA-G5
is an inhibitory constituent and may exert a key effect
219/ Iran J Allergy Asthma Immunol, Spring 2015
Published by Tehran University of Medical Sciences (http://ijaai.tums.ac.ir)
Vol. 14, No. 2, April 2015
S. Abediankenari, et al.
Figure1. The comparison of relative expression of two isoforms of HLA-G (HLA-G7 and G5) in abortion-threatened women
and the control group.
on T cell proliferative response. Also, it is possible that
the decrease of soluble HLA-G5 contribute to allogenic
CD4+ T cell proliferative responses in semiallogenic
fetus. On the other hand, HLA-G5 may be an important
molecule for stimulating of T regulatory cells in the
healthy pregnant women. In addition, HLA-G has an
important role in secretion of IL-10 and TGF-β by T
cells.10 Thus, one of the abortion factors in abortionthreatened women could be down-regulation of
inhibitory cytokines by cell-bearing HLA-G5. It is
concluded that further studies are needed on the role of
HLA-G5 in pregnancy.
ACKNOWLEDGEMENTS
This study was supported by Mazandaran
University of Medical Sciences (grant No.91.1436).
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